Six years of the Malone-Lee approach and I'm still in pain - though I've had good periods too. Any advice?

So I've been doing the Malone Lee approach of long term antibiotics since 2020. I've been pain free off and on. I had 2 years pain free on keflex, but I've been flaring again since march and haven't had any success with amoxicillin or azithromycin.

I'm wondering if the ideology of not testing for a specific pathogen really makes sense? I did a micro genx years ago and got a whole bunch of different things including ureaplasma.

I'm about to get the Uromune vaccine but I'm worried it won't help at all based on that micogenx from 2019 not showing e coli or kleisbella. After that the phage thing they do in Tblisi is my last idea, I think I've tried everything else (d mannose, hiprex, pelvic floor physio, urethral dilatation, meditation/ therapy, probiotics, cutting out diff foods, opioids, cannabis, antihistamines, anti convulsants, OTC pain meds, steroids, lidocaine, oestrogen, BV and thrush treatments, IV abx etc etc - and I've been celibate for over a year now)

Any thoughts? I've been suffering on and off for maybe 15 years, and I have a tear in my urethra from CSA which is probably how the bacteria gets in in the first place.